Permit CITY OF TIGARD
- � � 11
DEVELOPMENT SERVI ELECTRICAL
ENERGY
PERMIT #: ELR98 -0016
DATE ISSUED: 01 /29/98
PARCEL: 15126C0 -01107
SITE ADDRESS...:09724 SW WASHINGTON SQUARE RD
SUBDIVISION ZONING:C —G
BLOCK • LOT • JURISDICTN: TIG
Project Description : Misc.: Signal circuit or a limited energy panel, alteration
or extension to an existing tenant occpy.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO...: AUDIO & STEREO..: INTERCOM & PAGING..:
BURGLAR ALARM • BOILER • LANDSCAPE/ IRRI GAT. .
GARAGE OPENER CLOCK • MEDICAL
HVAC • DATA /TELE COMM..: NURSE CALLS •
VACUUM SYSTEM • FIRE ALARM • OUTDOOR LANDSC LITE:
OTHER: .• HVAC • PROTECTIVE SIGNAL..:
INSTRUMENTATION.: OTHER.. :LIM—ENERGY: :X
TOTAL # OF SYSTEMS: 1
Owner: FEES
THE GAP type amount by date recpt
9724 SW WASHINGTON SQUARE ROAD PRMT $ 40.00 GEO 01/29/98 98- 302887
TIGARD OR 97223 5PCT $ 2.00 GEO 01/29/98 98- 302887
Phone #:
Contractor:
CHANDLER ELECTRIC INC $ 42.00 TOTAL
3521 SW CARSON ST
PO BOX 80696 REQUIRED INSPECTIONS
PORTLAND OR 97280 -1696 Low Voltage Insp
Phone #: 245 -7774 Elect'1 Final
Reg #..: 000949
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180
days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rule adopted by the
Oregon Utility Notification Center. Those rules are set forth in DAR 952- 001 -0010 through OAR 952 - 001 -080. You may obtain copies of
these rules or direct esti s t (5031246 -1987. `
Issued by Per mittee Signature
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for
sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' N: DATE: /—
LICENSE NO:
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
rd
CITY 0I TIGARD Electrical Permit Application Plan Check #
13125 SW HALL BLVD. Rec'd By
TIGARD OR 97223 Date Rec'd
Date to P.E.
Phone (503) 639 -4171, x304 to DST
Inspection (503) 639 -4175 Print or Type Permit # e-eL C °y±joi4.
Fax (503) 684 -7297 Incomplete or illegible will not be accepted Called
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development
Andaiv Numb of Inspections per permit allowed
Name (or name of business) G Service Included: Items Cost Sum
Address c? c? 0� Y W + r M - AL. S� �d 4a. Residential ft o t es- per unit $110.00 -
City /State /Zip r�� -i v Each additional 500 sq. ft. or 4
Commercial Residential ❑ portion thereof $25.00 1 - Limited Energy $25.00
Each Manul'd Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder $68.00 2
(Attach copy of all current ii es) // 4b. Services or Feeders
Electrical Contractor Ch IJ!rcoGl w �l -Yr, c j,h. c_ Installation, alteration, or relocation
Address 06e x s, / 4 (0 200 amps or les $60.00 2 -
201 amps to 400 amps $80.00 2 -
City TL C State f) 2 Zip 971R4 -/L 96 401 amps to 600 amps $120.00 2
-
Phone No. zc1 2 7 7 N 601 amps to 1000 amps $180.00 2
Job No. 3? 4Tq 6' Over 1000 amps or volts $340.00 2
Reconnect only $50.00 2
Elec. Cont. Lice. No. ZG- S. ti L Exp.Date /D -/- 9' S -
OR State CCB Reg. No. 9 1 /4D g Exp.Date 11-12 -93 4c. Temporary Services or Feeders
COT Business Tax or Metro No. I D f r' Exp.Date 7-9R Installation, alteration, or relocation
/� �
200 amps to or less $50.00 2
-
Signature of Su r. Elec'n IlA // 201 amps to 400 am ps $75.00 2
9 / p 401 amps to 600 amps. $100.00 2
-
ver 80 amps to
License No _ gS S Exp.Date / o -/ -q g D see " b' above. 1000 volts,
LO •
Phone Nc. 2 e/ S-- 7 7 7 4d. Branch Circuits
New, alteration or extension per panel
2b. For owner installations: a) The fee for branch circuits with
purchase of service or
Print Owner's Name feeder fee.
Address Each branch circuit $5.00 - 2
City State Zip b) The fee for branch circuits
ty p without purchase of
Phone No. service or feeder fee.
First branch circuit $35.00 2
The installation is being made on property I own which is not Each additional branch circuit $5.00 2
intended for sale, lease or rent. 4e. Miscellaneous
(Service or feeder not included)
Owners Signature Each pump or irrigation circle $40.00 - 2
Each sign or outline lighting $40.00 2
3. Plan Review section (if required):* Signal circult(s) or a limited energy
panel, alteration or extension I $40.00 I l e a °r 2
Minor Labels (10) $100.00
Please check appropriate Item and enter fee In section 58.
4 or more residential units in one structure 4f. Each additional inspection over
Service and feeder 225 amps or more the allowable in any of the above
System over 600 volts nominal Per inspection $35.00
Classified area or structure containing special occupancy Per hour $55.00
as described In N.E.C. Chapter 5 In Plant $55.00
* Submit 2 sets of plans with application where any of the above apply. 5. Fees: 4 O
Not required for temporary construction services. 5a. Enter total of above fees $
5% Surcharge (.05 X total fees) $ 2 • ek
NOTICE Subtotal $
Sb. Enter 25% of line 5a for
PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS Plan Review jf reauired (Sec.3) $
NOT COMMENCED WITHIN 180 DAYS, OR IF CONSTRUCTION OR WORK Subtotal $
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED. ❑ Trust Account # 04 ,
Total balance Due $